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Ohio Department of Aging Aging Connection

Medicare 2011 annual enrollment periodNow is the time to check your plan

Medicare open enrollment runs Nov. 15 through Dec. 31. During this time, consumers can change how they receive their health coverage and add, change or drop drug coverage. Changes made during Fall Open Enrollment take effect Jan. 1, 2011. With passage of the healthcare reform law, it is especially important that consumers check their Medicare plan to ensure it is still a good fit and meets their needs.

At the beginning of this year, Medicare consumers who reached the donut hole received a $250 rebate. Starting in January 2011, Medicare consumers will see greater discounts for prescription drugs sold either as a separate Part D plan or as part of bundled Medicare Advantage coverage. The health care law offers a 50 percent discount from drug makers in the "donut hole," when drug benefits temporarily stop. Officials also say more insurers are expected to offer plans that cover the gap.

Medicare consumers have two options in receiving their Medicare benefits: either through Original Medicare or a Medicare Advantage plan, an option approved by Medicare, but run by private companies. With Medicare Advantage plans, a consumer generally gets all his Medicare-covered health care, including prescription drug coverage, as well as extra benefits, such as coverage for vision, hearing, dental or health and wellness programs.

Under the health care reform law, there are no cuts to the Original Medicare benefit.

Medicare Advantage plans will face some changes as a result of health care reform. First, government will no longer subsidize these private plans. On average, the plans cost the government 13 percent more than Original Medicare. Second, in the future Medicare Advantage plans that are higher quality (four or five stars) will receive a bonus payment that must be used in part to expand benefits. This will give the higher quality plans a competitive advantage over time. The actual cost of Medicare Advantage for consumers declines by 1 percent on average next year. Some private Medicare plans have dropped out, primarily because of a 2008 law that requires these plans meet more stringent quality requirements. Overall, about five percent of consumers will have to choose new providers because their Medicare Advantage plans have dropped out, according to U.S. health officials.

The Medicare Plan Finder allows beneficiaries to compare plan offerings. Professionals can visit MyMedicareCommunity, which is supported and moderated by the National Council on Aging, for updated information throughout the fall enrollment season.

The Ohio Department of Insurance, through the Ohio Senior Health Insurance Information Program (OSHIIP), is hosting Medicare Check-up Days in most Ohio counties. Medicare Check-up Days give beneficiaries the opportunity to meet a trained counselor and review their Medicare and Medicare Part D prescription drug benefits. Consumers also can call OSHIIP at 1-800-686-1578 to receive a free comparison of the Medicare health and prescription drug plans available in Ohio and an explanation of other programs that may help pay drug costs.

Medicare coverage and costs can change from year to year, but especially now during the implementation of health care reform. It is worth taking the time to see if your plan still works for you.

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New PACE provider
The Ohio Department of Aging is proud to welcome McGregor PACE Center for Senior Independence as the new provider of PACE services in Cuyahoga County. The Program of All-Inclusive Care for the Elderly, or PACE, is a managed care model that provides participants with all of their needed health care, medical care and ancillary services in acute, sub-acute, institutional and community settings. Services include primary and specialty care, adult day health services, personal care services, inpatient hospital, prescription drug, occupational and physical therapies and nursing home care. Visit our website for more information.